【摘要】 目的初步分析腹壁缝合穿刺针辅助小儿腹腔镜阑尾切除术的临床疗效与优势。方法回顾性分析山东大学齐鲁医院(青岛)小儿外科2016年5月至2017年12月本院收治的55例小儿急性阑尾炎患者的临床资料,其中34例采用腹壁穿刺针辅助法治疗,21例采用传统三切孔法治疗,比较两组手术时间、术中出血量、肛门排气时间、术后住院时间、术后切口感染率等指标。结果 55例均治愈出院,术后随访6～12个月,穿刺针组与三切孔组的手术时间分别为(36. 3±5. 8) min和(55. 1±6. 3) min,差异有统计学意义(t=3. 853,P <0. 05);穿刺针组与三切孔组的术中出血量分别为(4. 9±1. 9) m L和(8. 3±3. 8) m L,差异无统计学意义(t=0. 980,P> 0. 05);穿刺针组与三切孔组的肛门排气时间分别为(27. 1±8. 1) h和(26. 3±8. 9) h,差异无统计学意义(t=2. 785,P <0. 05);穿刺针组与三切孔组的术后住院时间分别为(6. 0±1. 6) d和(6. 9±3. 1) d,差异无统计学意义(t=0. 432,P> 0. 05);穿刺针组与三切孔组的切口感染率分别为2%和3%,无统计学差异(χ2=0. 030,P> 0. 05)。结论采用穿刺针辅助腹腔镜阑尾切除术治疗小儿急性阑尾炎安全有效,手术时间更短,术后疤痕更加隐蔽、美观。更多还原

【Abstract】 Objective To explore the clinical efficacies and advantages of abdominal wall suture needle assisted laparoscopic appendectomy in children. Methods The clinical data of 55 hospitalized children with acute appendicitis from May 2016 to December 2017 were retrospectively analyzed. Among them,34 cases underwent abdominal wall puncture needle assisted operations and 21 cases were traditional three. Two groups were compared with regards to operative duration,intraoperative blood loss,anal exhaust time,postoperative hospital stay and postoperative incision infection rate,etc. Results All of them were cured and discharged. The followup period was 6-12 months. The operative duration of puncture needle and three-cut groups was( 36. 3 ± 5. 8)and( 55. 1 ± 6. 3) min and the difference was statistically significant( t = 3. 853,P < 0. 05); intraoperative blood loss( 4. 9 ± 1. 9) and( 8. 3 ± 3. 8) m L and there was no statistical difference( t = 0. 980,P > 0. 05); anus exhaust time( 27. 1 ± 8. 1) and( 26. 3 ± 8. 9) hours and there was no statistical difference( t = 2. 785,P < 0. 05);postoperative hospital stay( 6. 0 ± 1. 6) and( 6. 9 ± 3. 1) days and there was no statistical difference( t = 0. 432,P> 0. 05); rate of incision infection 2% and 3% and there was no statistical difference( χ2= 0. 030,P > 0. 05).Conclusion Puncture needle assisted laparoscopic appendectomy is both safe and effective for acute appendicitis in children. With a shorter operative duration,postoperative scar is more concealed and esthetic.更多还原